Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Luze, H.
Autologous Fat Grafting in Reconstructive Breast Surgery
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Medizinische Universität Graz; 2022. pp. 80
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Kamolz Lars-Peter
- Spendel Stephan
- Altmetrics:
- Abstract:
- Background: Autologous fat grafting is an effective tool for soft-tissue augmentation in reconstructive breast surgery. Despite the great advantages of this minimally-invasive approach, the unpredictability of graft survival, which is only about 40% of the original infiltrated volume, is a challenge. The inadequate take rate is often mandating several grafting sessions for an optimal, yet unpredictable outcome, resulting in a tremendous burden for patients and healthcare systems. No clear consensus on the optimal technique has been published yet and well-defined prospective studies investigating impairing factors are lacking. The present project aimed to generate valuable baseline data in order to contribute to an optimization and standardization of this valuable method in the future. Methods: 10 female patients undergoing elective autologous fat grafting after subcutaneous, nipple-sparing mastectomy were enrolled. Punch biopsies and lipoaspirates were obtained from the harvest site for histological, gene expression and scanning electron microscopic analysis. Non-invasive Lipometer measurements to determine the thickness of the subcutaneous adipose tissue at the graft site were used to calculate the respective take rate. Patient- and surgery-related data were acquired and correlated with the take rate. Results: A statistically significant correlation between the take rate and the existing mean subcutaneous adipose tissue thickness at the grafted breast prior to surgery was observed. An approximate correlation was identified regarding the number of prior grafting sessions, body weight and BMI. No statistically significant correlation was demonstrated for the age, harvest site, or the mean adipocyte size. Lower levels of cell damage were observed in scanning electron microscopic samples of washed lipoaspirates; and a strong indirect correlation was encountered with the expression of the adipocyte markers FABP4 and PLIN1. Conclusions: We were successful in identifying factors that correlate with the take rate. Future studies investigating the clinical relevance of each impairing factor determined are essential to contribute to the optimization of this valuable method.